NHS in a capitalist economy...

TruckerT

The NHS continues to come under fire, but many NHS professionals remain firmly committed to 'looking after people'.

How long can this last?

My own recent experience of the NHS is mixed - I have met very poor standards of care in my offprings' neonatal needs, but I have also had a very good experience of A&E.

My own health concerns have been largely met with a box-ticking approach, which has so far not led to any serious failures (I hope!).

In pre-capitalist groups, the mortality rates were high, but we are led to believe that the levels of care were guaranteed.

TruckerT

LydiaJ

Sorry to hear about your offspring, TruckerT.

TruckerT

LydiaJ wrote: »

Sorry to hear about your offspring, TruckerT.

Tomorrow, I plan to force my offspring to climb a hill - they are well used to it, and these days they bring their young...

TruckerT

michaels

We are too wedded to public sector provision rather than merely sector purchasing of health care. I believe we spend nearly as much as the French on healthcare with considerably worse outcomes, in their system whilst the state pays for it provision is generally private doctors who provide the care.

BobQ

I think that any institution as big as the NHS has the potential to do magnificent things while is equally capable of failing its clients. I have experienced excellent care and poor care for me and mine and I suspect that others have a similar experience.

I recall visting my A&E Department with a relative who was experiencing a major but not urgent problem. The target culture meant she was sitting on a trolley outside the A&E suite in a corridor with about 20 other patients all on a trolley queuing down the corridor. I am sure that being outside the A&E suite was useful in meeting a target (treatment had started) as patients in the corridor were taken out of the queue into a room and given tests before being returned to a different position in the queue.

I spent over an hour at the front of the queue with my relative. We were outside the A&E suite on one side of an open door and two metres away on the other side of the open door was a huge whiteboard on which the problems of the A&E department were mapped out by three senior nurses who were permanently occupied juggling slots, ringing wards, bed managers, and countless other people, while debating the solutions of the A&E. It was evident from their conversation that two of the nurses had been working 6 hours without a break and were very stressed out. It was also evident that phrases like "breaches" and "close to the four hours" and the like were being bandied about and medical conditions were only of concern to the extent they impacted on the logistics of getting people into and out of the A&E suite.

It was also evident that none of their deliberations had anything to do with rendering healthcare to those in the A&E suite or the corridor, it was simply a logistical exercise in managing workload of the type that probably happens in lots of businesses delivering a service. This is what happens when you run at 100% capacity but cannot control the demand for the service. But it was a huge waste of the professional expertise of the nurses involved. I accept that the decisions being made needed their professional expertise but had the hospital been operating at a lower capacity a lot their time could have been devoted to what they had been trained to do.

TruckerT

BobQ wrote: »

I think that any institution as big as the NHS has the potential to do magnificent things while is equally capable of failing its clients. I have experienced excellent care and poor care for me and mine and I suspect that others have a similar experience.

I recall visting my A&E Department with a relative who was experiencing a major but not urgent problem. The target culture meant she was sitting on a trolley outside the A&E suite in a corridor with about 20 other patients all on a trolley queuing down the corridor. I am sure that being outside the A&E suite was useful in meeting a target (treatment had started) as patients in the corridor were taken out of the queue into a room and given tests before being returned to a different position in the queue.

I spent over an hour at the front of the queue with my relative. We were outside the A&E suite on one side of an open door and two metres away on the other side of the open door was a huge whiteboard on which the problems of the A&E department were mapped out by three senior nurses who were permanently occupied juggling slots, ringing wards, bed managers, and countless other people, while debating the solutions of the A&E. It was evident from their conversation that two of the nurses had been working 6 hours without a break and were very stressed out. It was also evident that phrases like "breaches" and "close to the four hours" and the like were being bandied about and medical conditions were only of concern to the extent they impacted on the logistics of getting people into and out of the A&E suite.

It was also evident that none of their deliberations had anything to do with rendering healthcare to those in the A&E suite or the corridor, it was simply a logistical exercise in managing workload of the type that probably happens in lots of businesses delivering a service. This is what happens when you run at 100% capacity but cannot control the demand for the service. But it was a huge waste of the professional expertise of the nurses involved. I accept that the decisions being made needed their professional expertise but had the hospital been operating at a lower capacity a lot their time could have been devoted to what they had been trained to do.

My question remains - "how long can this last?"

TruckerT

Thrugelmir

TruckerT wrote: »

The NHS continues to come under fire, but many NHS professionals remain firmly committed to 'looking after people'.

How long can this last?

As long as people continue to live and longer lives more and more difficult. Not helped by a capitalist [STRIKE]economy[/STRIKE] society where ones own financial wellbeing is often more important than helping others. More often or not close relatives.

CKhalvashi

michaels wrote: »

We are too wedded to public sector provision rather than merely sector purchasing of health care. I believe we spend nearly as much as the French on healthcare with considerably worse outcomes, in their system whilst the state pays for it provision is generally private doctors who provide the care.

And I think that this is the best system to work on, as does my mother (who is one of the UK's leading Radiology specialists)

The issue comes here when we get doctors stating that they want £250k+ a year, and a better package, and refuse to budge on that.

CK

TruckerT

michaels wrote: »

We are too wedded to public sector provision rather than merely sector purchasing of health

CKhalvashi wrote: »

And I think that this is the best system to work on, as does my mother (who is one of the UK's leading Radiology specialists)

The issue comes here when we get doctors stating that they want £250k+ a year, and a better package, and refuse to budge on that.

CK

I really don't know whether to laugh or cry! That's not meant to be a cynical joke in any way - it's just that I really can't think of a way forward which might work.

TruckerT

wotsthat

I find it quite surprising that the government are all for competition but Europe's biggest employer is owned by the state.

If competition is so vital that even directory enquiries has to be privatised then why won't is work for healthcare?

I don't see my GP much but I'm sick of going and being asked if I've got BUPA. i.e. my problem is severe enough for someone else to pay but not the NHS.

BobQ

TruckerT wrote: »

My question remains - "how long can this last?"

TruckerT

How long can what last?

The commitment of its health professionals may not live much longer. Over generations we are witnessing a change in attitude. My generation did not always seek a career in the public sector but always regarded it as a worthy occupation, particularly in professional occupations like teaching, nursing science and accountancy. Many leaving school today view those who work in the public sector as lazy, overpaid and unproductive. This attitude means that there is a decreasing number of people who view public service positively and an increasing number who see it as just another job. Ultimately this will take its toll, and people will simply follow the money or the interesting work and have no loyalty to the job and relatively little dedication to the patient.

The NHS will last as long as we elect governments who are committed to it. Fundamentally there is no reason why efficient services cannot be provided in a public sector organisation. But the drive to reduce costs and the political motivation to privatise services will also take its toll. While making a profit from efficiencies is a laudable aim, if this is done by reducing wages, worse terms of employment, the level of commitment of the staff will also fall. It is of course possible to make a profit by delivering good quality services more efficiently but so often those doing it reduce quality and demotivate staff.